Health Care Financing

Orrick has a national health care finance practice that encompasses financings for publicly owned hospitals and health care providers, private nonprofit hospitals and health care providers and proprietary organizations. Orrick ranks among the top firms nationally.

Since 1985, attorneys in Orrick’s Health Care Financing Group have served as bond, underwriter’s or special tax counsel in over 1,270 issues aggregating more than $90 billion. We have worked with a range of issuers, including state authorities, cities, counties, hospital districts, local authorities, joint powers authorities, and nonprofit corporations. Orrick has also guided public entities through general obligation elections and issues for public health facilities.

Representative Projects and Programs Financed

• academic medical facilities
• acquisition financings for health care restructuring
• Alzheimer's facilities
• ambulatory care centers
• bloodbanks
• centers for abused women and children
• community mental health programs
• continuing care communities
• health maintenance organizations
• hospices
• hospital equipment purchase pool programs
• hospital loan and lease pool programs
• hospitals (purchase, construction, expansion, renovation, remodeling , seismic retrofit and equipment), including children’s hospitals, university hospitals and academic medical centers
• life care centers
• medical clinics
• medical foundations
• medical institutes for special diseases
• reference laboratories
• rehabilitation facilities
• research facilities
• skilled nursing facilities
• working capital financings, including receivables financings

Unmatched Experience in Health Care Financing

Our experience includes structuring program financings for construction, equipment, and working capital for both publicly owned and private nonprofit health care providers. Regarding lease/leaseback and sale/saleback certificates of participation financing of health care facilities, we have more experience than any other firm. Additionally, we have worked extensively with credit pooling and credit enhancement structures pertaining to health care financing, including the following vehicles:

• obligated group and credit group financings based on a variety of master trust indentures
• intra- and inter-system guarantees and lines of credit
• letters of credit and standby purchase agreements issued by state, national and international banks
• bond insurance issued by public entities and private companies
• interest rate swaps and other hedges
• combinations of the foregoing, including wraps of credit providers

Our Experience With Issuers and Conduit Borrowers

We have acted as Bond Counsel or Underwriters’ Counsel with respect to bonds issued by the following entities (among others):

• ABAG Finance Authority For Nonprofit Corporations
• Berks County Municipal Authority
• Brevard County, Florida Health Facilities Authority
• California Health Facilities Financing Authority
• California Infrastructure and Economic Development Bank (I-Bank)
• California Statewide Communities Development Authority
• Charleston County, South Carolina
• City of Dearborn Economic Development Corporation
• City and County of Denver
• City of Fresno
• City of Lansing Hospital Finance Authority
• City of Montgomery, Special Care Facilities Financing Authority
• City of Newport Beach
• Clarian Health
• Colorado Health Facilities Authority
• County of Los Angeles
• County of Santa Barbara
• County of Maricopa, Industrial Development Authority (AZ)
• County of Montgomery, Ohio
• Delaware Health Facilities Authority
• Dormitory Authority of the State of New York
• El Camino Hospital District
• Health, Educational Housing Facilities of Knox, Tennessee
• Hesperia Public Financing Authority
• Hospital Board of Directors of Lee County, Florida
• Indiana Health Facility Financing Authority
• Kentucky Development Finance Authority
• Massachusetts Health and Educational Facilities Authority
• Mesa County
• Michigan State Hospital Finance Authority
• Mississippi Hospital Equipment and Facilities Authority
• Montana Health Facility Authority
• New Jersey Health Care Facilities Financing Authority
• New York City Industrial Development Agency
• North Central Texas Health Facilities Development Corporation
• Palomar Pomerado Healthcare District
• Petoskey Hospital Finance Authority
• Pima County Industrial Development Authority
• State of Hawaii
• The Regents of the University of California
• Travis County Health Facilities Development Corporation
• Tri-City Healthcare District
• Vermont Educational & Health Buildings Finance Agency
• Waco Health Facilities Development Corporation
• Washington Health Care Facilities Authority

The transactions have financed facilities for the following health care providers, among others:

• Ascension Health
• Catholic Healthcare West
• Christiana Care Health Services
• Daughters of Charity
• El Camino Hospital
• Exempla Health
• Hoag Memorial Hospital
• Intermountain Healthcare
• Jefferson Health System
• Kaiser Permanente
• Lee Memorial Health System
• Lenox Hill Hospital
• Memorial Sloan-Kettering Cancer Center
• Miami Valley Hospital
• Mt. Sinai/NYU Health Obligated Group
• North Mississippi Health Services
• North Shore-Long Island Jewish Health System
• Scripps Health
• Sharp Healthcare.
• St. Barnabas Health Care System
• St. Joseph Health System
• St. Mary’s Medical Center of Saginaw, Inc.
• Sutter Health
• UCSF – Stanford Health Care
• Valley Health System
• West Penn Allegheny Health System